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Community Health Infrastructure

I mentioned in my last post that reform efforts will be beneficial to immigrants when navigating the health system, though this is also true for millions who turn to health centers and clinics for care. As primary care access continues to become more and more strained, effective networks of community health clinics are vital to populations, particularly those in low-income rural and urban areas. Reform includes significant investments in these institutions through grants to increase the numbers of clinics and school based health centers. Competitive grants will also be available to established local government and community-based organizations who implement proven disease management strategies/effective medical home models in order to promote these practices nationwide. Patients utilizing these systems will have improved access to timely care, especially those requiring continuous treatment for chronic conditions.

In addition to the patient-centered benefits, clinics will benefit greatly from reform in terms of their own operational health. Community clinics serve much larger proportions of uninsured and low-income individuals, and face significant financial strain as a result. For example, in 2006 California community clinics provided $231 million in uncompensated care totaling nearly 12% of total revenue. Increases in the number of insured will greatly reduce the amount of uncompensated care, and increases in Medicaid reimbursement rates will provide a much needed boost in revenue for these safety net clinics. Increased federal contributions in addition to these revenue boosts will give clinics breathing room to invest in their infrastructure (particularly in health information technology and clinical workforce supply) in order to streamline administrative efficiency and better coordinate care for their patients.